Student Admission Application
Office of Admissions
Official Application Receipt
Reference No. ACNHS-ADM-2025-001
Application Barcode
ACNHS-ADM-2025-001-ABCD
I. Applicant Identity
Full Name
Applicant Name
Date of Birth
January 1, 2000
Gender
Female
Nationality
Armenian
Place of Birth
Yerevan, Armenia
II. Citizenship & Immigration
Armenian Citizen
—
US Immigration Status
—
Last Visit to Armenia
—
Date Left Armenia
—
III. Contact & Residence
Primary Email
applicant@email.com
Primary Phone
1 555 123 4567
Alternate Phone
—
Current Address
Address line
IV. Program Selection
| Program of Study | Intended Start | Previous Application |
|---|---|---|
| Associate Degree in Nursing (ADN) | Fall Semester 2026 | No, first-time applicant |
V. Academic Background
High School Diploma
Institution Name
Field of Study
Graduated 2023 · GPA 3.80
VI. Emergency Contact
Contact Name
Relationship: Parent
Phone: 1 555 000 0000
VII. Document Checklist
| Required Document | Status |
|---|---|
| Passport Copy | Received |
| Diploma / Degree Certificate | Received |
| Official Transcripts | Received |
| English Proficiency Results | Not Provided |
| Letters of Recommendation | Optional |
VIII. Personal Statement
Applicant statement will appear here.
This receipt confirms that the Armenian College of Nursing & Health Sciences has received the above applicant's submission and supporting documentation as itemised herein. Verification of authenticity and completeness shall be conducted by the Office of Admissions. All official communications pertaining to this application will reference ACNHS-ADM-2025-001.
Applicant Signature
Confirmed
Date of Submission
Authorized — Office of Admissions
Consent Granted
Confidential · Do Not Alter · Valid Only With Official Seal
Armenian College of Nursing & Health Sciences · acnhs.am
Figure A.1 — Official Photo Specification Diagram · Armenian College of Nursing & Health Sciences